Jill L. Dickie, LISW-SUPV

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.0000437-SUPV Issued in OH

Practice address

3922 Lovers LN
Ravenna, OH 44266-4200

Phone

(330) 673-1347

Fax

(330) 678-3677

NPI assigned

Jun 2, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coleman Professional Services, Inc.

  • Mental Health Counselor
  • Kent, OH
  • NPI 1982637633

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1184850323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5982 RHODES RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404128",
            "telephone_number": "330-673-1347",
            "fax_number": "330-678-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3922 LOVERS LN",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442664200",
            "telephone_number": "330-673-1347",
            "fax_number": "330-678-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKIE",
        "first_name": "JILL",
        "middle_name": "L.",
        "credential": "LISW-SUPV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0000437",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0000437-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Elizabeth Denny, MA
• Mary D Deperro, LISW
• Joy Anna Devlin, OT
• Ashley Lynn Dewiel
• Shurouq Diab
• Kevin S Ditchey
• Jolie Doan
• Julie Dobson
• Dana Angela Donovan, LPN
• Paige Doremus

• Clinical Social Worker in Ravenna, OH
• Providers in Ravenna, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.